Information Collection Request

Ryan White HIV/AIDS Program Client-Level Data Reporting System

ICR 202506-0906-004 · OMB 0906-0039 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 3 Client Level Data on File Form and Instruction Modified Available
Form 2 Provider Report Form and Instruction Unchanged Available
Form 2 Provider Report Form and Instruction Unchanged Repair queued
Form 1 Recipient Report Form and Instruction Unchanged Available
Form 1 Recipient Report Form and Instruction Unchanged Repair queued
HRSA HAB RSR Non-Substantive Change Memo _ OMB 0906 0039_ 06132025_v2.0_Draft_Final.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-06-30 Available
HRSA HAB RSR Non-Substantive Change Memo _ OMB 0906 0039_ 06132025_v2.0_Draft_Final.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-06-30 Repair queued
Tab A - 2009 RWHAP Legislation.pdf Supplementary Document Uploaded 2021-11-16 Available
Tab A - 2009 RWHAP Legislation.pdf Supplementary Document Uploaded 2021-11-16 Repair queued
Supporting Statement A - RSR 2024 Final 07012024.docx Supporting Statement A Uploaded 2024-07-16 Available
Supporting Statement A - RSR 2024 Final 07012024.docx Supporting Statement A Uploaded 2024-07-16 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
269447 Client Report Form and Instruction ModifiedClient Level Data on File
269447 Client Report Other-Redline Modified
269446 Provider Report Form and Instruction UnchangedProvider Report
269446 Provider Report Form and Instruction Unchanged
269445 Recipient Report Form and Instruction UnchangedRecipient Report
269445 Recipient Report Form and Instruction Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2027 09/30/2027 09/30/2027
4,190 0 4,190
206,480 0 206,480
0 0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Client Report 3
Provider Report 2
Recipient Report 1

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 4,190 4,190 0 0 0 0
Annual Time Burden (Hours) 206,480 206,480 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No